Nokea
The afferent path of the sneeze reflex is mediated via the
- A. Ophthalmic nerve V1
- B. Maxillary nerve V2
- C. Mandibular nerve V3
- D. Vagus nerve
Correct Answer: B
Rationale: The sneeze reflex is triggered by irritation of the nasal mucosa, which is innervated by the maxillary nerve (V2). The reflex involves the trigeminal nerve and medullary centers.
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When assessing the patient's speech, the nurse should look for:
- A. Any slurred speech or difficulty articulating words.
- B. Normal tone and rhythm of speech.
- C. Absence of speech abnormalities.
- D. Clear and coherent communication.
Correct Answer: A
Rationale: Slurred speech or difficulty articulating words may indicate neurological issues. Normal tone, absence of abnormalities, and clear communication are expected findings.
The nurse determines what about the caregiver?
- A. The caregiver is also developing signs of AD.
- B. The caregiver is manifesting symptoms of caregiver role strain.
- C. The caregiver needs a period of respite from care of the patient.
- D. The caregiver should ask other family members to participate in the patient's care.
Correct Answer: B
Rationale: Symptoms like inability to concentrate indicate caregiver role strain
A female client informs the nurse that she overstretched her arm muscles when lifting a heavy suitcase, and now experiences inflammation, some tenderness, and muscle spasms. Which of the following problems is she most likely to have?
- A. Strain
- B. Contusion
- C. Sprain
- D. Avulsion fracture
Correct Answer: A
Rationale: A strain involves muscle or tendon injury, fitting the described symptoms.
What functions does the thalamus have?
- A. Registers auditory input
- B. Integrates past experiences
- C. Relays sensory and motor input to and from the cerebrum
- D. Controls and facilitates learned and automatic movements
Correct Answer: C
Rationale: The thalamus serves as a relay station for sensory and motor inputs to the cerebrum.
A previously healthy 68-year-old male presents with progressive muscle weakness in his right hand, swallowing difficulty and difficulty with walking. He believes these symptoms occurred "out of the blue" and have worsened over the last 2-3 months. His temperature is 98.6 deg F (37 deg C), blood pressure 145/86 mmHg, pulse is 80/min, and respirations are 17/min. Neurologic examination is significant for mild dysarthria. He has atrophy of the thenar muscles of the right hand and forearm, and 2/5 strength on wrist extension and flexion, as well as 3/5 power in intrinsic hand muscles on right. He has some fasciculations in his right thigh, and mild (4+/5) weakness of hip flexors bilaterally. Tone is increased in both legs. Sensory examination is intact. 3+ patellar reflexes are noted on the left lower extremity. On gait testing, the patient has poor balance, and spastic gait. Which of the following is the most likely diagnosis?
- A. Guillain-Barre syndrome
- B. Amyotrophic lateral sclerosis
- C. Myasthenia gravis
- D. Multiple sclerosis
Correct Answer: B
Rationale: The patient's presentation of progressive muscle weakness, atrophy, fasciculations, and spasticity with hyperreflexia is classic for amyotrophic lateral sclerosis (ALS). ALS involves both upper and lower motor neuron degeneration, leading to a combination of weakness, atrophy, and spasticity. The absence of sensory deficits and the presence of bulbar symptoms (dysarthria, swallowing difficulty) further support this diagnosis. Guillain-Barre syndrome typically presents with ascending paralysis and areflexia, while myasthenia gravis is characterized by fatigable weakness without atrophy or fasciculations. Multiple sclerosis and dermatomyositis do not fit the clinical picture.